J Korean Hip Soc.  2010 Mar;22(1):52-57. 10.5371/jkhs.2010.22.1.52.

Risk Factors for Dislocation after Primary Total Hip Arthroplasty with the Transtrochanteric Approach

• Hwang KT
• Kim YH
• Kim YS
• Bong HJ
• Choi IY

• KMID: 1461077
• DOI: http://doi.org/10.5371/jkhs.2010.22.1.52

Abstract

PURPOSE
We wanted to evaluate the risk factors that predispose a patient to dislocation after undergoing primary total hip arthroplasty with the transtrochanteric approach.
MATERIALS AND METHODS
Between July 1995 and May 2007, 593 consecutive total hip arthroplasties using the trantrochanteric approach were performed. A matched comparative study was performed for the dislocated group(18 hips) and the non-dislocated control group(18 hips). The patient-related factors and mechanical factors were retrospectively reviewed to evaluate the risk factors for dislocation.
RESULTS
Dislocation occurred in 18 hips(3.04%). The mean age was 57.1 years in the dislocated group and 55.2 years for all of the patients (p>0.05). Statistical analyses of the BMI, inclination and anteversion of the cup, lowering of the hip center, a leg length discrepancy, the size of the femoral head and nonunion of the greater trochanter revealed no significant differences between the two groups. Nonunion of the greater trochanter was observed in 16 hips(2.84%). The risk of dislocation was 8.5 times higher in the patients with excessive alcohol intake (p<0.05). The combination of more than 3 risk factors significantly affected the incidence of dislocation after total hip arthroplasty (p<0.05).
CONCLUSION
After primary total hip arthroplasty with the transtrochanteric approach, in the cohort of this study, excessive alcohol intake was the main risk factor for dislocation and a combination of risk factors contributed to dislocation.

Keyword

Hip dislocation; Total hip arthroplasty; Risk factor; Transtrochanteric approach

MeSH Terms

Arthroplasty
Cohort Studies
Dislocations
Femur
Head
Hip
Hip Dislocation
Humans
Incidence
Leg
Retrospective Studies
Risk Factors

Figure

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  Fig. 1 (A) Inclination of the cup is measured as the angle between the plane through the opening of the cup and the horizontal plane. (B) Anteversion of the cup is defined as the angle formed by the intersection of a line drawn across the face of the acetabulum and a line perpendicular to the horizontal plane.

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